Dear "60 Minutes":
As a psychologist with a long-term commitment to children with autism, I watched with great interest your recent segment "Apps for Autism." The encouraging picture you presented was welcome. Like many parents and many colleagues, I have seen the extraordinary array of skills that children on the spectrum can possess -- even when they are deemed to be "non-verbal" and severely limited in cognitive functioning.
At the same time, I was dismayed by serious failures and distortions in the material you presented. Briefly, what are the failures and distortions? First, the attraction that children with autism have for computers and high tech devices has been long known and described. Apps make high-tech tools more accessible and easier to use, but they do not reflect the quantum change your reporting suggested where children are enabled to become effective producers of language across a vast span of communication.
Second, the segment suggested that well-formed language was inside the individuals, just waiting for a means of expression (namely, the app). But the content of the apps that you showed was essentially a mirror of the language that has dominated teaching programs for decades. Essentially, that language reflects two basic forms: one is labeling or naming objects and people (e.g., using nouns to identify "ball, shoe, man," and so on); the other is language for expressing I want requests (e.g., making various statements about items and actions one hopes to have such as "I want banana" or "I want TV.")
Unfortunately, this content -- despite being widespread in use and expensive to implement -- does little to advance the children's development. As but one example, take the issue of naming. Imagine a child with autism mastering 1,000 nouns -- an attainable feat and one that leads many parents to feel a sense of triumph. Now, imagine taking those 1,000 nouns and trying to actually converse with someone. Within one word, you will realize that it is not possible to speak with a repertoire confined to nouns. Parents may take pleasure in seeing their children recognize objects, particularly when they represent relatively esoteric words such as "dinosaur" and "vehicle" and "locomotive." But the fact of the matter is that training in this area does nothing to enable a child to use language in a meaningful manner.
Consideration of "I want" request language involves different, but no less negative, forces. At first, parents are delighted to see their children making a range of requests. It leads them to believe that this is the start of meaningful interaction. They are convinced that if they show the children that their language "matters," their children are sure to relate better and to converse more. However, as many parents have found, "I want" request language rarely advances beyond "I want" request language. You essentially have a child who uses language to make endless requests and to do little else with his or her language.
As the children enter adolescence, the issue becomes even more problematic. It then is not simply a failure of language to advance, but a major breakdown in behavior. The children are now bigger and stronger and their wants have expanded -- often in realms that even the most giving of parents cannot permit. This leads the parents to deny the requests -- a move that leads the children to major acting out, often in aggressive and destructive ways. When viewed from the children's perspective, this is only reasonable. They have been encouraged for years to believe that the granting of what they want is of the highest priority to their parents. Now these vulnerable individuals see the basic pattern that they have relied on for years being challenged or rejected. What the parents then see is the ultimate outcome of encouraging "I want" language.
It would have been valid, albeit not inspiring, had you said that apps currently are a more attractive device for following the same methods that have long dominated the teaching of children with autism. But that was not your message. The segment clearly was aimed at saying that current apps represent major advances in opening up the invaluable tool of language for the children.
Admittedly, the failures and distortions do not rest with "60 Minutes" alone. The field itself has greatly contributed to the confusion. Since autism was first recognized, language and communication difficulties -- two vast and intricate domains -- have been acknowledged as central to the syndrome. This has naturally led intervention efforts to be focused on these realms.
It has led to something else as well. Its acknowledged importance has meant that one does not have to justify teaching language or communication. It's a "given." And "givens" invariably have unintended consequences. In this situation, one of the unintended consequences has been that program developers need not think, in depth, about precisely what skills can and should be taught. If it's language, it's "good."
This is what has permitted so many programs to concentrate on "naming" and "I want" language since these are the easiest forms of language to elicit. Think, for example, of how much easier it is to get a child to say the one-word name of an object than to generate a complete, meaningful statement about an object. When all language is seen as good, it's sensible to aim for the easiest types. Forces have allowed current intervention efforts to overlook the many disadvantages this "easier" language has for the ultimate development of effective language and communication.
Autism is a relatively new field. The syndrome was first described in the 1930s. Perhaps the situation that we are facing is an inevitable part of the growing pains of a new field. Regardless of the reasons, at this point in time, it is vital that the relevant disciplines (psychology, education, speech and language, neurology, etc.) begin to provide the long delayed, in-depth analyses of what language and communication skills can and should be taught to the children.
What "60 Minutes," with its prestige and power, might have done is to show the enormous potential of software in teaching children on the spectrum while at the same time offering insights into the current instructional situation where children, with and without apps, are not being provided the content that they need for their potential to be realized. That analysis is critical for parents of children with autism, as well as the society in general. Until "60 Minutes," or some comparable organization with a powerful reach, offers that analysis, we will continue to offer false hopes rather than real results.
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